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Biomedical subjects

G Schlierf

Publications and source records attributed to G Schlierf.

At least 73 records · Page 4Linked to original sources
PubMed1988

Low-fat diet and regular, supervised physical exercise in patients with symptomatic coronary artery disease: reduction of stress-induced myocardial ischemia.

The effects of physical exercise and normalization of serum lipoproteins on stress-induced myocardial ischemia were studied in 18 patients with coronary artery disease, stable angina pectoris, and mild hypercholesterolemia (total serum cholesterol 242 +/- 32 mg/dl). These patients underwent a combined regimen of low-fat/low-cholesterol diet and regular, supervised physical exercise at high intensity for 12 months. At 1 year serum lipoproteins has been lowered to ideal levels (serum cholesterol 202 +/- 31 mg/dl, low-density lipoproteins 130 +/- 30 mg/dl, very low-density lipoproteins 22 +/- 15 mg/dl, serum triglycerides 105 [69 to 304] mg/dl) and physical work capacity was improved by 21% (p less than .01). No significant effect was noted on high-density lipoproteins, probably as a result of the low-fat/high-carbohydrate diet. Stress-induced myocardial ischemia, as assessed by thallium-201 scintigraphy, was decreased by 54% (p less than .05) despite higher myocardial oxygen consumption. Eighteen patients matched for age and severity of coronary artery disease served as a control group and "usual medical care" was rendered by their private physicians. No significant changes with respect to serum lipoproteins, physical work capacity, maximal rate-pressure product, or stress-induced myocardial ischemia were observed in this group. These data indicate that regular physical exercise at high intensity, lowered body weight, and normalization of serum lipoproteins may alleviate compromised myocardial perfusion during stress.

Body Weight↗
PubMed1987

[Avoidable risks in the drug treatment of very old patients].

Among 196 patients with a mean age of 80 years there were, at the time of hospitalization, 12.2% who had been prescribed wrong or partly even high-risk medication drugs, some of which carried a high risk. Among 694 prescriptions 4.2% were faulty. The faults consisted of failure to take account of impaired renal function, contraindications, accompanying illnesses, and misinterpretation of side-effects. 80% of these prescriptions were for diuretics, psychoactive and antiarrhythmic drugs, digitalis and hypnotics. The number of faulty prescriptions on discharge was 1.4%. In all, the average number of prescribed drugs had decreased from 3.5 on admission to 2.9 on discharge. This retrospective study demonstrates that the manner of prescribing for elderly patients needs to be handled more critically and rationally.

Age Factors↗
PubMed1987

[Prevalence of Gilbert's syndrome in Germany].

The prevalence of Gilbert's syndrome was studied in a randomized group of 1530 persons (785 men and 745 women, aged 20-40 years) living in the Heidelberg region of the Federal Republic of Germany. It was found to be present in 12.4% of men and 4.8% of women, i.e. a total of 8.6% for the entire group. In women the serum bilirubin level (mean 12.0 +/- 5.1 mumol/l) was significantly lower than in men (mean of 13.7 +/- 6.8 mumol/l; P less than 0.001). Analysing the frequency distribution of serum bilirubin revealed that patients with this syndrome do not constitute a population of its own, but rather form the upper end of the normative bilirubin distribution curve.

Adult↗
PubMed1987

Mitigation of alimentary lipemia by postprandial exercise--phenomena and mechanisms.

The effects of a single bout of exercise at 40% of maximum aerobic capacity with regard to alimentary lipemia and postprandial lipoproteins was studied in a cross-over design in 12 young healthy male volunteers. In addition to lipids and lipoproteins, lipoprotein lipase, free glycerol, free fatty acids, plasma insulin, and C-peptide concentrations were quantitated. Postprandial exercise reduced alimentary lipemia by 34% while lipoprotein lipase activity rose by 42%. The postprandial fall of high-density lipoprotein (HDL)3 was abolished and the rise of HDL2 accentuated. Free glycerol and free fatty acid concentrations were higher following the meal plus exercise regimen compared to the meal alone. It is concluded that at least part of the chronic effect of exercise may come from additive effects such as observed from individual bouts of muscular activity.

Adult↗
PubMed1987

Metabolic effects and body fat mass changes in obese subjects on a very-low-calorie diet with and without intensive physical training.

During 4 weeks, 40 obese subjects (body mass index 30-45 W/H2) were treated with a 300-kcal mixed diet alone or in combination with exercise training on a bicycle ergometer in a metabolic ward. Exercise had a minor effect on body weight, reflected by an additional fat loss of 1.7 kg (expected loss: 4.0 kg). Hyperinsulinemia was improved by diet and normalized by diet combined with exercise; a similar effect was observed regarding C-peptide levels. Plasma concentrations of epinephrine and norepinephrine decreased in both groups. At maximal work, norepinephrine levels were higher in the group with exercise. Free fatty acids and free glycerol increased at rest as well as during exercise in subjects on both regimens, the difference being more pronounced in the exercise group. Enhanced oxidation of fat was substantiated by lower respiratory quotients during endurance exercise. Working capacity increased and blood pressure decreased considerably as a consequence of physical training. It is concluded that exercise training in addition to a hypocaloric diet lowers body weight and body fat, although to a lower degree than expected. During and following bouts of exercise, fat mobilization and oxidation is enhanced, but these effects are probably counteracted at rest. On the other hand, the diet-induced deterioration of physical performance is overcompensated.

Adipose Tissue↗
PubMed1987

Antilipolytic action of insulin in abdominal adipocytes of obese subjects before and during energy restriction. Influence of adenosine deaminase.

The influence of prolonged energy restriction (1250 kJ for 4 weeks) on insulin's antilipolytic action was investigated in abdominal adipocytes of obese subjects. An attempt was made to discriminate between dietary influences per se and indirect influences caused by changes in the concentration or action of adenosine. Prolonged energy restriction resulted in about a 3.5-fold increase in basal lipolytic rate which was associated with a corresponding increase in maximal response to insulin. Both these effects could be mimicked by adenosine deaminase (1.6 micrograms/ml) which increased glycerol release of adipocytes from fed donors to levels normally seen during starvation suggesting that the improvement of lipolytic responsiveness to insulin during energy restriction was an apparent one only, due to the fact that glycerol release was increased. To identify dietary influences that selectively affect insulin action the effects of insulin were compared with those of other antilipolytic agents in the presence of adenosine deaminase. Maximally effective concentrations of prostaglandin E2, clonidine and N6-phenylisopropyladenosine almost completely suppressed glycerol release before and during starvation. The extent of inhibition produced by these latter compounds was therefore related to basal activity by the same linear relationship in all experimental settings. By contrast insulin only partially depressed glycerol release and the relationships between basal activity and response to maximal concentrations of insulin were significantly different before and during starvation (P less than or equal to 0.01) in the presence of adenosine deaminase indicating that starvation selectively influences insulin action via mechanisms that are unrelated to the effects of other antilipolytic compounds. It is concluded that the main effect of energy restriction on insulin's antilipolytic action is an apparent one which is secondary increased lipolytic activity. Direct dietary effects on insulin action became apparent upon removal of endogenous adenosine. These tend to limit the maximal response to insulin and may be due to changes at the post-binding level but could also reflect an intrinsic property of insulin's antilipolytic action.

Abdomen↗
PubMed1987

Serum levels of free non-protein bound clofibrinic acid after single dosing to patients with impaired renal function of various degrees--a multicenter study.

As a basis for establishing dosing guidelines in order to avoid side effects due to overdosage, the concentrations of total and free non-protein bound clofibrinic acid (CA) were determined before and after the administration of a single clofibrate dose (0, 2, 6, 12, 24, 48, 72, 96h) in patients with various degrees of impaired renal function and in a control group (n = 56). The clofibrate doses administered to the five groups were: group 0 = control group without renal impairment: 1,000 mg; group 1 = serum creatinine up to 354 mumol/l: 1,000 mg; group 2a = creatinine levels greater than 354 mumol/l up to levels requiring dialysis: 1,000 mg; group 2b = creatinine levels like 2a, but only 500 mg; group 3 = patients requiring dialysis: 500 mg. In addition, serum albumin, CK, GOT and GPT were controlled. Total CA was determined by gas chromatography, the unbound fraction by equilibrium dialysis. Increasing serum creatinine levels were correlated with a decrease of total CA but with a statistically significant increase in free CA concentrations. The levels of non-protein bound CA of groups 1 and 2a were significantly different from control group 0 (same dosing). In addition, a significantly negative correlation between free CA and serum albumin levels was demonstrated. Determination of free CA as a control parameter of clofibrate therapy in patients with impaired renal function allows clofibrate dosing to be closer related to the individual subject than the determination of total CA only.

Adult↗
PubMed1986

[Combination therapy of obesity with a reducing diet and physical training. Cardiovascular and metabolic effects].

Twenty obese patients were either given a caloric restricted diet (300 kcal/d) over 4 weeks alone or underwent an additional ergometer exercise programme for up to 2 hours daily. Combination therapy resulted in an improvement of physical performance by 26% despite weight loss of 11 kg. Blood pressure could be reduced both at rest and on exercise. Blood pressure regulation and heart rate under orthostatic conditions remained unchanged for both therapeutical approaches. The effect on carbohydrate and lipid metabolism was also more favorable in patients on combination therapy than in those given a reduction diet alone. Combination of reduction diet and physical exercise is therefore superior to caloric restriction alone with regard to cardiovascular and metabolic considerations.

Adult↗
PubMed1986

Diurnal lipid and lipoprotein profiles in hypertriglyceridemic patients with bezafibrate and clofibrate.

Thirty hypertriglyceridemic patients were treated under metabolic ward conditions for 10 days with either placebo, clofibrate (500 mg t.i.d.) or bezafibrate (200 mg t.i.d.) in a randomized, double-blind study. In addition, patients received an isocaloric prudent diet. On day 10 a diurnal lipid and lipoprotein profile was carried out. Compliance to medication was good. Each treatment led to significant reductions of fasting triglycerides and cholesterol. Lowering of fasting and integrated diurnal triglycerides was greatest with bezafibrate. HDL-cholesterol profiles were highest with this drug. A strong correlation between fasting and diurnal triglycerides was observed. Triglyceride-lowering therapy must therefore aim at fasting triglyceride values as low as possible.

Adult↗
PubMed1986

Influence of bezafibrate on plasma lipoproteins, biliary lipids and fecal sterols in healthy men.

The effect of a 4-week treatment with 600 mg/day of bezafibrate in addition to a low-cholesterol, fat-modified diet on plasma lipids and lipoproteins and on biliary lipids and fecal sterols was investigated in 12 healthy men aged 25-39, and compared to the effect of the diet plus placebo, using a double-blind crossover design. The comparison of placebo and treatment values indicated that bezafibrate, beyond the effect of the diet, significantly lowered concentrations of circulating triglycerides (-25.5%), total cholesterol (-25.8%), LDL cholesterol (-19.5%), and apolipoprotein B (-19.9%), and increased apolipoprotein A-II concentrations in serum (+15.0%). There was a tendency towards lower biliary bile acid and cholesterol secretion rates with bezafibrate; lithogenic indices in fasting and stimulated bile were similar with the drug and placebo. Fecal bile acid excretion rate with diet plus bezafibrate was significantly less than with diet plus placebo. The data obtained are in accord with the hypothesis that bezafibrate exerts its effects on cholesterol and bile acid metabolism predominantly by decreasing VLDL secretion, possibly through an enhancement of fatty acid beta-oxidation in the liver.

Adult↗
PubMed1986

The association of hyperlipoproteinemia with dysimmunoglobulinemia.

In a study of the immunoglobulin concentrations in an urban population and in patients with hyperlipoproteinemia we observed significant positive correlations between serum triglycerides and IgA independent of sex, age and body weight. In men serum triglycerides also correlated with IgG and IgM, and serum cholesterol with IgA. The prevalence of hyper- and hypoimmunoglobulinemia was significantly higher in hyperlipidemic than in normolipemic subjects. We propose that the occurrence of hyperlipoproteinemia with hypoimmunoglobulinemia may be caused by different pathobiological mechanisms than the occurrence with hyperimmunoglobulinemia.

Adult↗
PubMed1985

Antilipolytic effects of N6-phenylisopropyladenosine and prostaglandin E2 in fat-cells of obese volunteers before and during energy restriction.

The antilipolytic effects of N6-phenylisopropyladenosine and of prostaglandin E2 were studied with adipocytes of obese volunteers before and after 4 weeks of severe energy restriction [1250 kJ (300 cal)/day] in the presence and absence of adenosine deaminase (1.6 micrograms/ml, corresponding to 320 m-units/ml). The studies were undertaken to define more clearly the role that local modulators might play in adaptation of lipid mobilization to starvation in humans. Starvation was associated with an approx. 3-fold increase in non-stimulated lipolysis. Removal of endogenous adenosine resulted in a similar increase in basal glycerol release under both conditions, averaging 2 and 2.2 mumol/180 min per 10(6) cells respectively. The sensitivity of the cells to N6-phenylisopropyladenosine and to prostaglandin E2 was not changed by starvation in the presence of adenosine deaminase. These results are discussed in terms of the possible role that local regulators might play during dietary adaption in human fat-cells in vitro.

Adenosine↗
PubMed1985

[Long-term therapy of familial hypercholesterolemia in young patients with colestipol: availability of minerals and vitamins].

Longterm treatment for 5 years of young patients with familial hypercholesterolemia was accompanied by monitoring of plasma levels of calcium, iron, sodium, parathyroid hormone and water- and fat soluble vitamins, since interference of the ion exchange resin with absorption of numerous substances as well as abnormal plasma levels of some of the above had been described in several studies. Treatment was effective in the group with good compliance (lowering of plasma cholesterol at the end of 5 years by 19% and, compared to the control group, by 23%). Adverse drug effects with respect to the above parameters were not found. Plasma levels of carotinoides and vitamin E were elevated in the patients according to elevated concentrations of lipoproteins which are carriers of these vitamins.

Adolescent↗